Individual provider Active NPI

Bernard Bryan Bulcourf, PH.D.

  • Psychologist
  • Gainesville, FL
National Provider Identifier
1336125848
Registry record updated Jan 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PY6591 Issued in FL
Practice address
4881 NW 8TH Ave
Suite 2
Gainesville, FL 32605-4582
Phone
(352) 224-2486
Fax
(352) 331-6550
NPI assigned
Dec 16, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PY6591 FL Primary

Addresses

Primary practice location

4881 NW 8TH Ave
Suite 2
Gainesville, FL 32605-4582

Mailing address

4881 NW 8TH Ave
Suite 2
Gainesville, FL 32605-4582
Phone (352) 373-6338

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100312000176 FL Practitioner - Clinical Psychologist 6709911068 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
University of Florida College of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Simedhealth LLCGroup PAC ID 6608137054, 89 clinicians

Practice addresses (Care Compare)

4343 W Newberry Rd
Gainesville, FL 32607-2817
Phone (352) 416-1082

4881 NW 8TH Ave
Suite 2
Gainesville, FL 32605-4582
Phone (352) 416-1082

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83 of 100Reported as group
Quality
65.57
Promoting interoperability
99
Improvement activities
40
Cost
78.6

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PY6591FLMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Simedhealth LLC CurrentSince Apr 1, 2018 Accepting new patients
Simed Health LLC CurrentSince Apr 1, 2018 Accepting new patients

Locations

4881 NW 8th Ave
Ste 2
Gainesville, FL 32605
Phone (352) 373-6338

4741 NW 8th Ave
Ste A
Gainesville, FL 32605
Phone (352) 374-9790

4343 Newberry Rd
Gainesville, FL 32607
Phone (352) 224-2200

3305 SW 34th Cir
Ste 101
Ocala, FL 34474
Phone (352) 373-4321

Networks

  • Freedom Health HMO Network

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1134691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264723200000",
    "number": "1336125848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4881 NW 8TH AVE",
            "address_2": "SUITE 2",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326054582",
            "telephone_number": "352-373-6338",
            "fax_number": "352-373-6144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4881 NW 8TH AVE",
            "address_2": "SUITE 2",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326054582",
            "telephone_number": "352-224-2486",
            "fax_number": "352-331-6550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULCOURF",
        "first_name": "BERNARD",
        "middle_name": "BRYAN",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-16",
        "last_updated": "2010-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY6591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.